title: Post-traumatic infection of the lower limb caused by rare Enterobacteriaceae and Mucorales in a young healthy male.
abstract: Enterobacter amnigenus and Leclercia adecarboxylata are gram-negative aerobic bacilli of the family Enterobacteriaceae that have been isolated from water and, rarely, from various clinical specimens. Absidia is a filamentous fungus of the class Zygomycetes that is ubiquitous in nature and can cause infection, primarily in immunocompromised hosts. Here, we describe an infection of the left lower limb caused by E. amnigenus and L. adecarboxylata with subsequent isolation of Absidia spp. in a patient with multiple traumatic injuries after a major motor vehicle accident. The severity of the clinical picture made amputation necessary, despite aggressive anti-infective therapy with both antibacterial and antifungal agents. Prompt diagnosis and management are mandatory in order to minimize morbidity and even mortality, and reduce the social and economic cost.
authors.affiliation: Infectious Disease Unit, University of Florence School of Medicine, Careggi Hospital, Florence, Italy. giampaolo.corti@unifi.it
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Corti
authors.forename: Nicola
authors.initials: N
authors.lastname: Mondanelli
authors.forename: Michele
authors.initials: M
authors.lastname: Losco
authors.forename: Laura
authors.initials: L
authors.lastname: Bartolini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fontanelli
authors.forename: Franco
authors.initials: F
authors.lastname: Paradisi
mesh_terms: D020095:Absidia / Q000145:classification / Q000302:isolation & purification; D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D004754:Enterobacter / Q000145:classification / Q000302:isolation & purification; D004755:Enterobacteriaceae / Q000145:classification / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D006801:Humans; D035002:Lower Extremity / Q000293:injuries*; D008297:Male; D009090:Mucorales / Q000145:classification / Q000302:isolation & purification*; D009091:Mucormycosis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents